The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care. . .'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Copyright

Human duodenal mucosal brush border Na⁺/H⁺exchangers NHE2 and NHE3 alter net bicarbonate movement

The proximal duodenal mucosa secretes HCO[Formula: see text] that serves to protect the epithelium from injury. In isolated human duodenal enterocytes in vitro, multiple luminal membrane proteins are involved in acid/base transport. We postulated that one or more isoforms of the Na+/H+exchanger (NHE) family is located on the apical surface of human duodenal mucosal epithelial cells and thereby contributes to duodenal mucosal HCO[Formula: see text] transport. Duodenal biopsies were obtained from human volunteers, and the presence of NHE2 and NHE3 was determined by using previously characterized polyclonal antibodies (Ab 597 for NHE2 and Ab 1381 for NHE3). In addition, proximal duodenal mucosal HCO[Formula: see text] transport was measured in humans in vivo in response to luminal perfusion of graded doses of amiloride; 10−5–10−4M amiloride was used to inhibit NHE2 and 10−3M amiloride to inhibit NHE3. Both NHE2 and NHE3 were localized principally to the brush border of duodenal villus cells. Sequential doses of amiloride resulted in significant, step-wise increases in net duodenal HCO[Formula: see text] output. Inhibition of NHE2 with 10−5M and 10−4M amiloride significantly increased net HCO[Formula: see text] output. Moreover, there was an additional, equivalent increase ( P &lt; 0.05) in duodenal HCO[Formula: see text] output with 10−3M amiloride, which inhibited NHE3. We conclude that 1) NHE2 and NHE3 are localized principally to the brush border of human duodenal villus epithelial cells; 2) sequential inhibition of NHE2 and NHE3 isoforms resulted in step-wise increases in net HCO[Formula: see text]output; 3) NHE2 and NHE3 participate in human duodenal villus cell HCO[Formula: see text] transport; and 4) the contribution of NHE-related transport events should be considered when studying duodenal HCO[Formula: see text] transport processes.</jats:p

Esporre ed esporsi al mondo dall'antichità alla contemporaneità. Atti della Summer School Exposizioni (Milano, 2-12 giugno 2015). Vol. 1

Che cosa implica oggi per uno studioso di scienze umanistiche esporsi ed esporre? Significa paragonarsi con il contesto nel quale si è immersi. Significa aprirsi al mondo, comunicare, verificare, proporre, imparare, all’interno delle diverse forme espressive che costituiscono il terreno del proprio ambito disciplinare: letteratura, arte, archeologia, filosofia. Gli atti della Summer School “EXPOsizioni. Esporre ed esporsi al mondo dall’antichità alla contemporaneità” promossa nel 2015 dalla Scuola di dottorato in “Studi umanistici. Tradizione e contemporaneità”, in occasione dell’EXPO Milano 2015, raccolgono le relazioni tenute da docenti dell’Università Cattolica e da prestigiosi ospiti provenienti da Università e centri di ricerca italiani ed europei in cui ogni studioso, partendo dalle competenze scientifiche e dal punto di vista del proprio specifico settore disciplinare, tratta un argomento specifico che consente di evidenziare i motivi, le modalità e le finalità che lungo i secoli, in ambiti geografici e in situazioni diverse, hanno caratterizzato la comune scelta di esporsi o di esporre al mondo qualcosa o qualcuno